Metal-induced diseases of the oral mucosa
Introduction
Introduction to metal-induced oral mucosal diseases Metal elements are easily absorbed by the oral mucosa and can cause stomatitis, gingivitis, angina, etc., which can become an early clinical manifestation or the only symptom of metal poisoning. basic knowledge The proportion of illness: the incidence rate is about 0.003%-0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: phosphorus poisoning osteomyelitis
Cause
Metal-induced etiology of oral mucosal diseases
(1) Causes of the disease
1. Chronic mercury toxic stomatitis: caused by long-term occupational exposure or application of amalgam, accumulated in connective tissue, mercury particles arranged along the cluster of collagen fibers, rarely induced exogenous granuloma.
2. Chronic lead toxic stomatitis: caused by long-term exposure, and more related to occupational exposure.
3. Chronic sputum toxic stomatitis: the incidence rate is high, mostly caused by oral or topical sputum preparations.
4. Chronic silver toxic stomatitis: related to long-term occupational exposure or the use of silver living utensils.
5. Chronic arsenic toxic stomatitis: related to occupational exposure or long-term use of arsenic.
6. Chronic gold toxic stomatitis: related to long-term use of gold preparations or gold dentures, may cause delayed allergic reactions in the body.
7. Chronic chromium toxic stomatitis: related to the accumulation or contact of chromium in the body.
(two) pathogenesis
The pathogenesis is still unclear.
Prevention
Metal-induced oral mucosal disease prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Metal-induced complications of oral mucosal diseases Complications, phosphorus poisoning, osteomyelitis
Chronic phosphorus toxic stomatitis can cause osteomyelitis and necrosis of the jaw.
Symptom
Metal-induced symptoms of oral mucosal diseases Common symptoms Congestive dizziness, nasal congestion, mucous membrane, dry abscess, stomatitis, papules, redness, fatigue, gastrointestinal symptoms
1. The clinical manifestations of chronic mercury toxic stomatitis have three major characteristics
(1) Ulcerative stomatitis, ulcers and a wide range, accompanied by swelling of the gums, hemorrhage, gum abscess, grayish to brownish black mercury lines in the gums, causing loosening of the gums.
(2) Increased saliva, thick and sticky, causing dry lips, cracks, swelling.
(3) Gastrointestinal symptoms, such as colic, diarrhea, etc., other may be accompanied by dizziness, headache, insomnia, irritability, irritability and so on.
2. Chronic lead toxic stomatitis
Lead accumulates in the capillary wall and macrophages of the gingival capillaries, forming a lead line, which is one of the early clinical symptoms of lead poisoning. It is especially obvious in patients with gingivitis and calculus. Children are rare, because children's metal deposits on bone, lead line Gray, located 1mm near the border of the iliac crest, consisting of dark gray particles arranged in a line, often accompanied by gingivitis, sputum stomatitis or ulceration, increased salivation, metallic taste in the mouth, systemic fatigue, dizziness , headache, memory loss and digestive tract, respiratory symptoms and peripheral neuropathy.
3. Chronic sputum toxic stomatitis
The sputum granules deposited on the oral mucosa of capillary endothelial cells and connective tissue are locally blue-brown or purple-brown, which occurs in the gingival margin and interdental nipple, which is linear, sometimes affecting the lip mucosa and buccal mucosa, or There are ulcerative stomatitis and bad breath. The skin of the whole body is blue-gray, which may have gastrointestinal dysfunction and kidney changes.
4. Chronic silver toxic stomatitis
Mainly manifested as permanent skin mucosal hyperpigmentation, oral, gingival mucosal pigmentation is diffuse, no subjective symptoms, often found in the examination, skin, nail bed, especially exposed parts, pigmentation due to sunlight, dark gray Or purple, which can be accompanied by a smooth metal.
5. Chronic arsenic toxic stomatitis
Stomatitis pain is obvious, mucous membrane is dry, dark red color, sometimes forming erosion and ulcer, garlic smell in the mouth, swollen gums, congestion, bleeding, pigmentation similar to lead line, systemic chronic gastrointestinal symptoms, liver and kidney function Disorders and polyneuritis, diffuse pigmentation of the skin, eczema dermatitis and keratosis.
6. Chronic phosphorus toxic stomatitis
The main symptoms are gingival congestion, swelling, bleeding, acupuncture, ant feeling or unbearable pain, garlic smell in the mouth, can cause osteomyelitis of the jaw, necrosis, suppuration or fistula formation, so-called phosphorus poisonous jaw gangrene.
7. Chronic gold toxic stomatitis
Mainly showing purple pigmentation of gingival mucosa, flushing of oral mucosa, and blistering, ulceration, dryness and cracking of the lips.
8. Chronic chromium toxic stomatitis
Mainly manifested as dry mouth mucosa, ulcer at the bottom of the mouth, congestion of the nasal mucosa, edema, accompanied by nasal congestion and burning sensation, early congestion of the inferior turbinate, ulceration in the late stage, skin ulcers in the shape of a corn, large grains to broad beans, clear boundary, convex edge From the surface, there are gray dry suede, no redness around, but visible papules, small blisters or secondary sores.
Examine
Metal-induced examination of oral mucosal diseases
1. Chronic lead toxic stomatitis caused by long-term exposure, and more related to occupational exposure.
2. Chronic mercury toxic stomatitis is caused by long-term occupational exposure or application of amalgam, which is caused by accumulation in connective tissue. Mercury particles are arranged along the cluster of collagen fibers and rarely induce exogenous granuloma.
Can be diagnosed based on the above contact history.
Diagnosis
Diagnosis and differentiation of oral mucosal diseases caused by metal
According to the clinical manifestations, the characteristics of the lesions can be diagnosed.
